The Hills · CTP claims

A plain guide to CTP claims for Annangrove

The 28-day and 3-month deadlines, the Certificate of Fitness and weekly payments, explained plainly.

Most CTP claims begin the same way: an accident, a visit to the doctor and a form. What happens next depends on your injury, your work and the insurer's decisions. This guide explains each stage for people in Annangrove, with honest notes on when you can manage alone and when it's worth getting help from a lawyer, a doctor or allied health.

Postcode: 2156

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How a CTP claim unfolds over time

From the day of the crash to the two-year mark, this is how a typical claim for statutory benefits is timed. Your own claim may differ, especially if the insurer disputes something.

  1. Day 0

    The accident

    Your health comes first, then the paperwork. Report the accident to police, keep the event number, and write down the date, time and place while they're fresh, since the claim form asks for all three.

  2. Within 28 days

    Lodge your claim

    Lodge your claim for statutory benefits within 28 days of the accident so weekly payments can generally be back-paid to the day after. You can lodge through Service NSW online or with the CTP insurer.

  3. Within 14 days of your explanation

    A late claim, explained

    Lodged late, but inside 3 months, for an accident from 1 April 2023? Explain the delay fully. An explanation the insurer hasn't rejected within 14 days is treated as accepted, so back-pay can still apply.

  4. Within 3 months

    The last point to claim

    Three months after the accident is the practical cut-off. Later claims can only be accepted in limited circumstances, usually with a full and satisfactory explanation. If you're past it, speak to a lawyer straight away.

  5. Weeks 1–13, then 14+

    Weekly payment rates

    Weekly payments are up to 95% of your pre-accident earnings for the first 13 weeks. From week 14 they're up to 80% or 85%, depending on your earning capacity. An indexed maximum applies.

  6. 52 weeks

    The threshold and at-fault line

    At 52 weeks, people with a threshold injury, and people wholly or mostly at fault, generally stop receiving weekly payments and treatment and care. For accidents between 1 December 2017 and 31 March 2023, that limit was 26 weeks.

  7. 104 weeks

    Weekly payments generally end

    At the 104-week mark, weekly payments generally end. They can run longer only while a common law damages claim is pending, and how much longer depends on the level of impairment.

General information, not legal advice. Dates depend on your accident date and circumstances. Rules change, so check the current rules.

Getting your claim in

You can lodge a claim for statutory benefits online through Service NSW, or directly with the relevant CTP insurer. If you're not sure which insurer that is, CTP Assist (1300 656 919) can help you identify it. The form asks about the accident, your injuries, your work and the treatment you've had so far, so have those details close by.

Not sure which insurer?

CTP Assist, run by SIRA, can help you work out which CTP insurer to claim against. Call 1300 656 919, 8:30am to 5pm weekdays.

Read next:CTP formsThe personal injury claim form

Why the Certificate of Fitness matters

The Certificate of Fitness is where your medical story meets the insurer. It lists your injuries and says what work, if any, you can do. If a certificate misses an injury or overstates your capacity, weekly payments may not reflect your situation, so read each one before it goes to the insurer and raise anything wrong with your doctor.

Read next:The Certificate of Fitness

Starting your claim from Annangrove

If Westmead Hospital treated you after a crash on the M2, Windsor Road or Old Windsor Road, gather those records before you lodge. They support the injury details on your claim form and your first Certificate of Fitness. Lodging a claim doesn't mean a trip to Castle Hill, 11 km away. From Annangrove, the claim form can be completed online, most insurer contact happens by phone and email, and our free claim check works the same way.

Region
The Hills
Postcode
2156
Nearest public hospital
Hawkesbury District Health Service
Distance to Castle Hill
~11 km
Two people going through a bound document together, one pointing at a clause

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Dealing with the insurer day to day

Insurers make decisions under the scheme rules, and your case manager is the person who passes them on. Most contact is routine: updated certificates, treatment approvals, payment questions. Reply promptly, keep copies of what you send, and ask for written reasons for any decision you don't understand. You can challenge decisions if you need to.

  • Keep copies of everything you send
  • Reply to requests promptly
  • Note the date on any decision letter

Read next:Dealing with your insurer and case manager

What you'll need to lodge

You don't need a perfect file to lodge. Start with the basics you have, then add documents as they arrive. Insurers generally ask for more information later, and it's better to lodge within 28 days with a gap in the paperwork than to wait for every page and lose back-pay.

  • Police event number
  • Date, time and place of the crash
  • Hospital discharge summary, if you were admitted
  • Your employer's name and contact details
  • Receipts for treatment, medication and travel

Read next:Checklist: your first 30 days

Threshold injuries and your benefit period

Some claims are capped at 52 weeks. For accidents on or after 1 April 2023, people whose injury is classed as a threshold injury can receive weekly payments and treatment and care for up to 52 weeks after the accident. The threshold label replaced the older term “minor injury” on that date. Whether an injury is threshold is a medical question in its own right; for running the claim, the point is the time limit it sets.

Read next:Threshold vs non-threshold injury

Weekly payments and treatment

Weekly payments replace part of your income while the injury keeps you off work or on reduced hours. The insurer sets your rate from what you earned before the accident, so give it the full picture from the start: every job you held and the hours you usually worked. A legislated maximum applies and is indexed each year, so the cap itself changes over time.

Keep in mind that treatment funding is a decision, not a given. Your treating team sends requests, and the insurer considers whether the treatment is reasonable and necessary. Keep receipts for anything you pay yourself. If a request is declined, you can ask for an internal review, generally within 28 days of receiving the decision.

Rules change

The scheme has changed more than once since 2017. What applies to you depends on your accident date, so check the current rules before relying on any detail.

Read next:CTP weekly paymentsCTP entitlements

When to get more help

If you lodged late, the stakes are higher: claims more than 3 months after the accident are accepted only in limited circumstances. The same goes if you've received a settlement offer or a letter you don't understand. In those situations, an independent lawyer's view is usually worth getting sooner rather than later.

Read next:What help do I need?

Do you need a lawyer to make a CTP claim?

Plenty of claims run from start to finish without legal help. A few need it early. If you recognise your situation below, you'll have a fair idea where you stand.

Often worth talking to a lawyer

  • The insurer has refused to accept the claim
  • Your claim went in more than 3 months after the accident
  • The insurer's reasons for a decision don't make sense to you
  • Your injury has been classed as threshold and your doctor disagrees

You may not need one

  • Your injury is healing well within the first months
  • You need help understanding a question on the form
  • Your weekly payments arrive on time and the amount looks correct

A claim runs on medical evidence. If you don't yet have a GP who'll complete a Certificate of Fitness, we can point you to doctors and allied health who know the CTP scheme.

Not quite your situation?

  • If you're not sure a CTP claim is even the right claim, for example because only your car was damaged, start with the car accident claim page. Car accident claim in Annangrove
  • If your main question is whether to bring in a lawyer, the CTP lawyer page for Annangrove explains when legal help is worth it. CTP lawyer in Annangrove
  • If a decision has already gone against you, the claim denied page explains internal review and what comes after it. CTP claim denied in Annangrove

Frequently asked questions

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CTP Lawyer is not a law firm. This page is general information, not legal advice; the independent lawyer you speak with can advise on your own situation.

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